Here's what's safe this fall when it comes to indoor activities

As society reopens and the weather gets colder, we're spending more time indoors in groups. If you're double vaccinated, you may be wondering what's safe when it comes to indoor activities this fall. 

"It depends on when you were vaccinated. It depends on who you are. Depends on where you live. And it depends on the nature of the indoor environment," said Raywat Deonandan, epidemiologist and associate professor in the faculty of health sciences at the University of Ottawa.

"In general, though, vaccination is awesome," Deonandan told Dr. Brian Goldman, host of White Coat, Black Art and The Dose. "It offers an awesome amount of protection, especially if everyone in the room is also vaccinated. So it's pretty good — but it's not perfect." 

The delta variant, he said, has detracted from the vaccination's ability to prevent initial infection, and has also affected its ability to prevent serious disease, hospitalization and death. If it's been several months since your second shot, the vaccine may have lost some efficacy.

With that in mind, Deonandan said there's a lot to consider when planning indoor activities. 

Restaurants, gyms and other indoor public places

Proof-of-vaccination requirements for indoor spaces help prevent virus transmission, said Deonandan. But that changes if there's more virus circulating in the community. 

"It's like wearing rain boots in floodwaters," he said. "If the floodwaters are high enough, the water will get over the lip of the boot and get your feet wet. So if the transmission rates in the community are high, you should be extra cautious."

If community infection rates are low, he said, your probability of being exposed in a restaurant is also low. 

"If you do become exposed to someone, then your vaccination and their vaccination will hopefully provide sufficient protection." 

Deonandan said wearing a mask in a restaurant when you're not at your table may also be helpful. 

"There is something to be said for the duration of time spent indoors properly wearing a mask, even if that time is not 100 per cent," he said. 

Since COVID-19 is airborne, said Deonandan, it's worth asking before going to a restaurant whether they use a HEPA or MERV filtration system.

"But even if they haven't got that level of high-quality filtration in place, do they have other endeavours in place to protect you," he said.

Use of high-quality masks, open windows, symptom checks and well-enforced proof-of-vaccine requirements add layering elements of protection and decrease your chances of being infected.  

Gyms are a little different, said Deonandan, because of mask mandates.

"In gyms, one presumes you're exerting yourself and exhaling forcefully. And we know that that kind of activity can produce more aerosols and propel them a further distance," he said. 

"But one is also presuming that somebody in a gym is properly wearing a mask at all times. I understand that is not always the case, however."

Make sure that your gym is enforcing mask mandates, requiring proof of vaccination and doing symptom checks, he said. 

'Living room spread' still a concern

Deonandan said the lack of vaccine requirements for gatherings in private residences in most provinces means they're still a risk for superspreader events.

If you're hosting an event, he said, try to politely broach the subject of vaccination with potential guests. 

If you invite unvaccinated guests, he advised encouraging those people to wear high-quality, well-fitted N95 masks. If you can get hold of rapid tests, he suggested asking guests to use them before attending. 

And make your guests feel good about staying home if they're feeling unwell.

"This should be the new normal," he said.

Safe choices vary depending on community spread

Experts like Deonandan also say it's important to factor community infection rates into decisions for the greater good.

Craig Jenne, an associate professor in the department of microbiology, immunology and infectious diseases at the University of Calgary, said the recent fourth wave means intensive care units in Alberta are still well above normal capacity. 

"We have to keep our eye on what the community is looking like at the moment, whether there is an increase before the holidays," he said. 

High case numbers led Alberta to place restrictions on gatherings in private residences in September, with a limit of two family cohorts and a maximum of 10 vaccinated adults allowed to gather in one home. 

"The key to keeping this under control is to stick to those guidelines," said Jenne.

"We have to still work to prevent those younger Canadians, younger Albertans, from getting infected," he said, noting that there are children with COVID-19 in intensive care in Alberta.

Take extra precautions for children

Deonandan said it's important to remember that there isn't time for kids between five and 12 to be fully vaccinated in time for the Christmas holidays. But partial vaccination would offer some protection. 

"That, layered on top of the rapid tests and the mask-wearing and the ventilation and the symptom checks, I think, are sufficient to make almost any indoor event safe enough," he said.

If you go into an event where children will be present, take extra precautions. 

"If you have an immunocompromised or a vulnerable person at home, maybe don't go to that event because a small child, if they're going to school or a daycare, is more likely to be carrying infection." 

'We're in a transition phase'

Dr. Sumon Chakrabarti, an infectious diseases physician at Trillium Health Partners in Mississauga, Ont., said with high vaccination rates, the need for detailed rules about indoor behaviour is no longer necessary.

"The landscape has completely changed," he said.

However, he also said everyone has a different level of emotional comfort with the return to social contact.

"We're in a transition phase where we're learning to live with it," he said. 

Make a personal risk assessment and do what you're comfortable with, he said, but make sure everyone you're socializing with is also on board. 

"If you're going to have, say, 20 people over and there's somebody you invite who's not comfortable with that, then that could ... make for a bad situation."  

Despite the strong protection offered by the vaccines, Deonandan said there are still good reasons to do your best to avoid catching COVID-19.

"This isn't just about hospitalization and death. It's about long-COVID disability," he said. "We don't fully understand long COVID yet. It's manifesting in strange ways." 

The more virus transmission that occurs, he said, the more likely it is to find people who are vulnerable to it. 

"The actions that I pursue today may not necessarily affect me and my family. It may affect the elderly couple two blocks away," he said. "We are all connected here, and pandemics have a way of reminding us [of] that." 

Written and produced by Rachel Sanders with files from Amina Zafar.